Walter Sisulu University
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Prevalence and Risk Factors of Traumatic Lumbar Puncture in Children at Nelson Mandela Central Hospital, Mthatha, Eastern Cape Province, South Africa
Get PDFTraumatic lumbar puncture signals improper procedural and proceduralist factors working on existing patient attributes. Occurrence is very common though believed to be overestimated and cut-off definitions are vague. Complications that follow incurs economic implications to the hospital setting due to high admission rate, long hospital stay and unnecessary use of antibiotics. None of these concepts around this topic is known in the present setting thus necessitating this research. The findings thereof would cause a fundamental change in the manner in which this procedure is performed in the present setting. Aim To determine the prevalence and risk factors of traumatic lumbar punctures, with the secondary goal of developing a protocol for performing appropriate lumbar punctures in order to reduce the rate of traumatic lumbar punctures. Methods An analytical cross-sectional data using retrospective data of 82 lumbar punctures performed over a four (4) month period from March to June 2022 at the paediatric emergency department of Nelson Mandela Central Hospital. Results Demographics characteristics: The median age was two (2) years (IQR = 0.83 – 3.35 years) and the highest proportion (53.66%) was observed for the age group two years and younger. Males constituted more than half (63.41%) of the population. Clinical features: Most of the children presented with seizures (56.10%) and high fever (46.34%). The top three conditions diagnosed were febrile seizures (40.24%), meningitis (17.07%) and acute gastroenteritis (9.78%). More females (20% p=0.047) suffered from acute gastroenteritis than males (3.8%).Thesis (Masters) -- Faculty of Medicine and Health Sciences, 202
A single centre study evaluating adherence to methotrexate monitoringguidelinesin patients with rheumatoid arthritis
Get PDFIntroduction: Methotrexate (MTX) is considered a first-line agent for the treatment of rheumatoid arthritis (RA) and regular blood test monitoring is advised in treatment guidelines to identify potential toxicity. Failure to adhere to monitoring guidelines for methotrexate use may compromise patient care. Identifying and correcting variability in care may optimise the safe use of this medication and improve patient outcomes. Aims: This study aimed to evaluate adherence to guidelines on methotrexate safety monitoring in rheumatoid arthritis patients at an Eastern Cape hospital and to establish whether a dedicated rheumatology outpatient department (OPD) performs this task more effectively than a general medical outpatient department (MOPD). Method: This retrospective cross-sectional single-centre study was conducted at Frere Hospital in the Eastern Cape over one year from 1 January 2019 to 31 December 2019. Adult patients over the age of 18 years who received methotrexate for rheumatoid arthritis during the study period and attended either the rheumatology OPD or the MOPD at Frere Hospital were included in the study population. Permission to undertake this study was obtained through the Faculty of Health Sciences Research Ethics and Bio-safety Committee at Walter Sisulu University and the Cecilia Makiwane and Frere Hospitals Research and Ethics Committee. The random sample generator tool on Microsoft Excel was used to select patients from the Frere Hospital Pharmacy Database who was prescribed methotrexate for rheumatoid arthritis. Laboratory test results were accessed through the Labtrak system of the National Health Laboratory Service (NHLS). The number and type of blood test done as recommended in a South African Methotrexate use guideline by Hodkinson et al, was documented on a data collecting sheet. Two or more blood tests done within a three-to six month period was considered adherent to the guideline. The hospital management system version two (HMS2) was used to see which clinic the patient attended. iii Results: There was 53% adherence (95% Confidence Interval 42-65%) overall to guideline. In the study sample, 64% of patients were from Rheumatology OPD and the remainder were from MOPD. There was 78% (95% CI 62-89%) adherence in the Rheumatology OPD compared to 22% (95% CI 11-38%) in MOPD. No significant association was found between the number of FBC tests and the site of testing (p-value = 0.346) or for Creatinine tests (p-value = 0.078). However, a significant association was found with ALT tests and the site of testing (MOPD or rheumatology OPD) with p-value = 0.010, although this is likely a chance finding. Conclusion: Adherence to a South African guideline for methotrexate safety monitoring was found to be suboptimal at the study centre. Adherence was better in the dedicated Rheumatology OPD compared to a general medical OPD. Education regarding the correct use of guidelines in different health settings by medical professionals is advised.Thesis (Masters) -- Faculty of Medicine and Health Sciences, 202
Recent progress in the conversion of agricultural waste into functional materials
No full textAgricultural waste is enriched with a variety of environmentally friendly materials that can potentially boost economic growth, reduce the spread of contagious diseases, and serve as a carbon-free renewable energy bioresource. Biopolymers produced from agricultural waste have a range of applications in medicine, agriculture, pharmaceutics, and industrial factories. The chemical extraction of biopolymers from biomass requires a series of alternating alkali, acid, and alkali treatments at controlled temperatures. Chemical extraction of plant-based biopolymers requires elevated temperatures (70–100°C), while for animal and sea organism-based biopolymers, moderate temperatures of 25–60°C are used. The obtained biopolymers are functionalized into various materials for application in a wide range of industries. The reported functional materials are loaded with inorganic nanomaterials, plant extracts, and organic compounds, which resulted in a synergistic effect and enhanced activity of the materials. Several researchers have synthesized biopolymers with synthetic polymers to improve their bioavailability, tensile strength, shelf life, and UV adsorption. This review article reports the extraction techniques of biopolymers from agricultural waste and their application in wound healing, water treatment, food storage, passive cooling, and cosmetics. The dearth of scientific articles on the applications of biopolymers generated from agricultural waste produced from food crops grown in Africa is a motivation for the present compilation
Ubulunga obusisiyaca obunentsimbi
No full textThe ubulunga obusisiyaca obunentsimbi, a necklace steeped in cultural significance, is crafted from pristine white beads interwoven with the supple tail hair of a heifer cow. This unique combination of materials symbolises purity and connects the wearer to the sacred realm of ancestral wisdom. Traditionally donned by diviners, and oracles who bridge the earthly and spiritual realms, this necklace serves as a channel for divine insight and guidance. Each bead and strand of hair carries with it a lineage of ancestral knowledge, passed down through generations. With its ethereal beauty and spiritual resonance, the ubulunga obusisiyaca obunentsimbi embodies the profound connection between the tangible world and the mystical forces that shape it, making it an indispensable artefact in traditional African spirituality.Purchased from Mrs Joan BrosterForms part of: Walter Sisulu University Beadwork Collectio
Ithumbu labantu abadala
No full textThe bead collar necklace, steeped in tradition and cultural significance, showcases a mesmerising blend of colors and patterns that captivate the eye and soul alike. Crafted in the classic design of bands featuring turquoise, navy, pink, and white, each bead meticulously placed to create a harmonious tapestry of hues. The subtle elegance of black pearls and white beads adorning the edges adds a touch of refinement to this timeless piece. Notably, the inclusion of pink signifies a passage into maturity, denoting the wearer's status within the older age group. Embraced by both adult males and females, this necklace transcends gender boundaries, serving as a unifying symbol of shared heritage and identity. As it graces the necks of its wearers, it becomes a tangible expression of cultural pride and unity, weaving together threads of tradition and belonging that resonate across generations.Purchased from Mrs Joan BrosterForms part of: Walter Sisulu University Beadwork Collectio
Isiyeye samaMpondomise
No full textThis intricately crafted bead strip neckband features a captivating design of white beads adorned with a navy river motif, complemented by a vibrant yellow fringe. Six elegant navy and white streamers cascade gracefully from the back of the neckband, secured with two pearl buttons, creating a striking ensemble. Worn with pride by adult men and women of the Mpondomise cultural group, this neckband symbolises their heritage and identity. Each bead and streamer carries the essence of their traditions and values, embodying the richness of their cultural tapestry. As they adorn themselves with these neckbands, individuals honour their ancestors and affirm their connection to their community and the land they call home. With its intricate design and vibrant colours, this bead strip neckband becomes more than just an accessory; it becomes a testament to the resilience, beauty, and spirit of the Mpondomise people.Purchased from Mrs Joan BrosterForms part of: Walter Sisulu University Beadwork Collectio
Inqawe yomfazana
No full textThe maiden's pipe is a treasured heirloom, rich in tradition and history, despite its youthful owner. With years of use, the bowl bears the marks of time, supported by metal bands that ensure its durability. While the simple pipe provides solace and companionship in everyday life, the beaded pipes hold a special significance in ceremonial attire. Known as "cool pipes," they are reserved for important occasions, serving as decorative pieces that symbolize the event's importance. Each bead on these pipes tells a story, woven into elaborate patterns that reflect her people's cultural heritage and traditions. During ceremonial rituals, the maiden carries herself with poise and respect, honouring her ancestors' legacy and the pride of her lineage with every fragrant puff of smoke.Purchased from Mrs Joan BrosterForms part of: Walter Sisulu University Beadwork Collectio
Isimamhlaba
No full textThe piece features a broad, flat throat band intricately designed with a series of beads. This ornate band is divided into panels, showcasing a captivating geometric pattern that draws the eye. Adorned with a decorative bell and complemented by a beaded body harness, this accessory symbolises a significant rite of passage, worn from the age of eighteen until the traditional ceremony known as "Umtshotsho." The design boasts an elaborate linework in striking navy and white bands, adding depth and elegance to the overall aesthetic.Purchased from Mrs Joan BrosterForms part of: Walter Sisulu University Beadwork Collectio
Ithumbu labantu abadala
No full textThe bead collar necklace represents tradition and culture, blending vibrant colours and intricate patterns that enchant the observer's eyes and spirit alike. It is meticulously crafted with bands of turquoise, navy, pink, and white beads, each thoughtfully placed to create a seamless tapestry of hues. Adding black pearls and white beads along the edges adds a touch of sophistication to this timeless piece. The presence of pink in the design symbolises a transition into maturity, signifying the wearer's status within the older age group. Embraced by men and women, this necklace transcends gender distinctions, serving as a unifying emblem of shared heritage and identity. As it adorns the necks of its wearers, it becomes a tangible expression of cultural pride and unity, interweaving threads of tradition and belonging that resonate across generations.Purchased from Mrs Joan BrosterForms part of: Walter Sisulu University Beadwork Collectio
A Comparative Analysis of PSA Trends of Conventional vs Hypo-fractionated External Beam Radiotherapy for the Treatment of Localised Prostate Cancer at Frere Hospital
Get PDFExternal beam radiotherapy with a moderate hypofractionated regimen has largely replaced conventional schedules. The change in regimen is based on the premise that prostate cancer, due to its low the alpha/beta ratio, demonstrates a higher sensitivity to a larger dose per fraction of radiation. Prostate Specific Antigen (PSA) is a specific indicator of prostate cancer treatment outcomes. The serum PSA trend is an indication of treatment response and risk for relapse. The time to nadir and the value of the PSA nadir are important predictors of biochemical control or failure. The lower the PSA level, the more durable the probability of maintained biochemical disease free survival. This study focuses on the biochemical control of patients treated with two different fractionation regimens at Frere Hospital. Aim To illustrate that the use of a moderate hypofractionated regimen for the treatment of intermediate and high risk prostate cancer is non inferior to a conventional regimen. Methodology The study took place at the department of radiation oncology, Frere Hospital, East London, Eastern Cape, South Africa. The study population consisted of 26 patients treated with conventional fractionation (2.00Gy x 36 fractions) in 2018 and 36 patients treated with the newly adopted hypofractionated regimen (3.00Gy x 20 fractions) in 2019. A comparison is made of the post treatment PSA trend over a 24 month period. Impact of study The study is projected to support the change in fractionation regimens at an institutional level. 2 Results: 41.9% of patients were enrolled in the conventional regimen, 58.1% were enrolled in the moderately hypo-fractionated arm. The participants were classified into high risk and intermediate risk in the two treatment arms and these were distributed equally. There was a clear decline in the serum PSA values over the two-year follow-up period. All four groups showed a similar pattern in that from the baseline to the first quarter, there was a sharp decline in the serum PSA values and this was significant for all four groupsThesis (Masters) -- Faculty of Medicine and Health Sciences, 202